Objectives: The extensive consume of β-lactam antimicrobial agents to treat patients with urinary tract infection has recently led to the emergence of resistant strains all over the world. The current study aimed to determine the prevalence of blaTEM, blaCTX-M & blaSHV genes in the Extended Spectrum β- Lactamase (ESBL) producing E. coli and K. pneumoniae isolates in urine samples collected from Dubai and Northern Emirates of U.A.E.
Materials/methods: A total of 3457 urine samples were collected between October 2018 and January 2019. 474 urine samples were reported as positive for urinary tract infection, in that, 130 bacterial isolates were identified as ESBL producers. Based on gram staining, culture characteristics, biochemical utilization, and double-disc diffusion test the ESBL producers E. coli and K. pneumoniae were identified. They were further screened for the presence of the targeted genes blaTEM, blaCTX-M & blaSHV.
Results: Out of 130 ESBL isolates, the class A ESBL genes blaTEM, blaCTX-M & blaSHV were detected only in 78 isolates. Among the 78 isolates, 59 positive amplifications were detected in E. coli and 19 were detected in K. pneumoniae. In that 59 E. coli isolates, the most predominant gene was blaTEM, followed by blaCTX-M and blaSHV. All the 03 genes were detected together in 02 E. coli isolates as well as 02 genes were together in 10 E. coli. Among the 19 K. pneumoniae, the gene blaCTX-M was predominant followed by blaTEM and blaSHV. There are 11 K. pneumoniae isolates had either blaCTXM + blaSHV genes or blaSHV
+blaTEM or blaTEM + blaCTX-M.
Conclusions: There is a high prevalence of ESBL producing gram-negative bacteria in the urine samples, with a higher prevalence in women than men and the number of E. coli strains is higher than K. pneumoniae. Due to the increase of E. coli and K. pneumoniae with multiple ESBL genes, continuous surveillance in order to use appropriate antibiotics and the control of infections is necessary.
Aishwarya Nair, Banasin Majeed, Hadija Begum, Nabila Rukshana, Mukesh Kumar Katheria, Nazeerullah Rahamathullah